Colleen wrote:

>Many women nurse on both sides, technically, while the vast majority of
>milk actually comes from only one side, and there's no problem!  I am a
>good example of this.  I've had surgery on both sides, lots of scar
>tissue and mastitis, and my kids all preferred the left breast and often
>refused the other.  My son currently only takes my right breast about 10%
>of the time.  You may want to warn the mom that her damaged side may, not
>will, just may, have a lower production, and the baby may prefer the
>other, just do what feels right and count wet diapers.  Normal, healthy
>babies can often regulate themselves nicely, if we just follow their
>lead....A real concern that I would seriously mention would be to watch
>for any nipple damage because she may not feel the pain.

Thanks for your comments.  I know that many moms seem to have a better supply
on one side than the other (many of our employees who come into my office to
use one of the big electric pumps while at work tell me that one breast
consistently produces significantly more milk--I never pumped while nursing
and couldn't tell any difference myself), and that other women have nursed
entirely from one breast without problems, but, since this woman has no
injury or scarring to the breast itself, only the loss of sensation, I hoped
it would be possible for her to feed on both sides.

My concern was not that the breast wouldn't produce, although I realize
that's always a possibility, but rather that she wouldn't have a sufficient
let-down on that side to allow adequate milk transfer and thus maintain
adequate production.   As other posters noted, and as I'm aware, of course,
the milk lets down in both breasts at the same time, but I was under the
impression that oxytocin continues to be released throughout the feeding, and
that, while most women are aware of only the first let-down, these occur
multiple times during a feeding.  Without that phenomenon, don't you think
there's a good possibility the breast won't empty complety?  That, of course,
<would> quickly lead to decreased production. Thus my questions about
possible manual stimulation or frequent switch nursing to continue oxytocin
stimulation to the affected breast.

I hadn't even thought of nipple damage!  You're absolutely right.  When I
talk to this woman tomorrow by phone to follow up with her, I'll caution her
to be alert to that. Thanks much for the input.

Judy Dunlap, RNC, BA, IBCLC